How Continuing Care Retirement Communities Work

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Continuing care retirement communities, also known as CCRCs or life plan communities, are a long-term care option for older people who want to stay in the same place through different phases

of the aging process.

There are about 1,900 CCRCs nationwide, according to the nonprofit National Investment Center for Seniors Housing & Care (NIC). They offer different types of housing and care levels based on

an older adult’s needs and how they change. 

Your loved one needs to be involved in the selection process.

LeadingAge, a nationwide organization of nonprofit and government aging-services providers, recommends that prospective residents ask these 10 key questions when considering a continuing

care retirement community.

1. Are you for-profit or not-for-profit, and what’s the financial strength of the retirement community?

2. What’s included in the monthly fee?

3. How do you help me to maintain my freedom and independence?

4. What kind of emergency response systems do you have?

5. How do you measure your residents' satisfaction? Can I see your last two surveys?

6. How may residents offer input and feedback?

7. What is the difference between independent and assisted living, and when would I have to move to assisted living?

8. Can you remain in independent living when your needs change, and how is aging in place supported?

9. What are  the five most popular programs in your community and who decides what programs and events are scheduled?

10. Can I review your residency agreement?

For example, a resident can start out living independently in an apartment and later transition to assisted living to get more help with daily activities, or to skilled nursing to receive

more medical care, while remaining in the same community.

The chief benefit of CCRCs is that they provide a wide range of care, services and activities in one place, offering residents a sense of stability and familiarity as their abilities or

health conditions change. But that comes at a cost.

Most communities charge an entry fee. The average initial payment is about $402,000, but the fees can range widely, from $40,000 to more than $2 million, according to NIC, which tracks costs

at some 1,100 CCRCs in 99 major U.S. markets.

Once residents move in, they pay monthly maintenance or service fees. Other continuing care communities operate on a rental model with no up-front fee. The average monthly charge across both

types of communities in the third quarter of 2021 was $3,555, and rents typically rise about 2 percent a year, NIC says.

CCRCs tend to have higher occupancy than standalone independent living, assisted living and nursing care communities and have seen less of a decline during the pandemic, according to NIC

data. CCRC occupancy rates dipped from 91.5 percent in the first quarter of 2020 to 84.3 percent a year later, but had inched back up to 85.4 percent by October 2021.

Here’s some information on how to find a CCRC and decide whether it’s the right place for your loved one to spend the rest of his or her life.

• Visit the federal government’s online Eldercare Locator or call 800-677-1116 to get contact information for your local Area Agency on Aging, which can provide information about CCRCs in

your area.

• LeadingAge, a member association for nonprofit eldercare providers, maintains an Aging Services Directory. To find a list of nonprofit communities, type in your state or ZIP code.

• Search for “retirement communities” or “retirement living” on the Yellow Pages website.

• Use an online referral service such as Caring.com or SeniorLiving.org.

Once you’ve compiled a list of communities you and your loved one would consider, gather more information on the web or by phone and narrow it down to places you want to visit.

Here are some things to look for and questions to ask when evaluating a community in person.